Non-invasive assessment of the Ionescu-Shiley pericardial xenograft heart valve.

This study was undertaken to describe the auscultatory, phonocardiographic, M-mode and two-dimensional echocardiographic features of the Ionescu-Shiley prosthesis in a group of unselected subjects. Twenty-seven valves were studied - 15 aortic, 10 mitral and 2 tricuspid. An opening sound was noted by phonocardiography and auscultation from the majority of valves in the three positions. A mid-systolic murmur was heard from 14 aortic valves and two had regurgitant murmurs. Three mitral valves had apical diastolic murmurs and two of these had mitral regurgitation. Two-dimensional echocardiography provided important spatial information but M-mode allowed superior resolution of valve leaflets. Calcification was seen in one four year old aortic valve and dehiscence of the sewing ring in another leading to severe aortic regurgitation. These data indicate that an opening sound is a frequent normal feature of an Ionescu-Shiley prosthetic valve and a mid systolic murmur is normal for aortic valves. In the three valve positions, the normal M-mode pattern resembles a native aortic valve. Abnormal features which can be recognized include calcification of valve cusps and dehiscence of the sewing ring.